Basic Information
| Provider Information | |||||||||
| NPI: | 1285897728 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LI | ||||||||
| FirstName: | NEWTON | ||||||||
| MiddleName: | TAK-YIP | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1051 W RAND RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600042315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476189510 | ||||||||
| FaxNumber: | 8476189506 | ||||||||
| Practice Location | |||||||||
| Address1: | 1051 W RAND RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600042315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476189510 | ||||||||
| FaxNumber: | 8476189506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2008 | ||||||||
| LastUpdateDate: | 05/05/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207K00000X | 036-127337 | IL | Y | Allopathic & Osteopathic Physicians | Allergy & Immunology |
ID Information
| ID | Type | State | Issuer | Description | 036127337 | 05 | IL | MEDICAID |